Q:
I hear so much talk about drug diversion in healthcare, how would I know if it was happening in my facility?
A:
Healthcare professionals and institutions must remain vigilant for signs of drug diversion to safeguard patients and facilitate appropriate intervention for those involved in diversion. Below are examples of behaviors that may signal substance use disorder (SUD) and/or diversion. It’s important to note that SUD can affect anyone, and the signs may manifest subtly.
- Discrepancies between documented medication administration and patient reports of not receiving medications.
- Unusual patterns in drug wastage, such as excessive wastage, lack of documentation, frequent disposal of drugs without patient administration (e.g., due to patient refusal or discontinued orders), and delaying wastage until the end of a shift.
- Involvement in medication orders beyond assigned duties, including reviewing orders for patients not under their care, assisting colleagues with medication administration, or offering to administer narcotics.
- Frequently requesting additional orders for controlled substances.
- Altering telephone or verbal medication orders.
- Changes in work performance, including recurrent errors, poor judgment, variable performance, shifting blame for mistakes, and exhibiting symptoms such as forgetfulness, drowsiness, euphoria, anxiety, or depression.
- Deterioration in personal relationships, frequent crises, social isolation, mood volatility, or withdrawal.
- Attendance-related red flags, such as excessive sick leave, tardiness, frequent absences, extended breaks, or unexplained disappearances during shifts.
- Eagerness for overtime shifts or volunteering to work on days off.
- Inconsistent attendance patterns, such as arriving late or leaving early.
- Inappropriate verbal or emotional responses to colleagues or patients.
- Observable signs of impairment, such as diminished alertness, confusion, or memory lapses.
- Physical manifestations of SUD, such as constricted pupils, sweating, chills, runny nose, appetite changes, itching, vomiting, diarrhea, or evidence of needle use.
By remaining attentive to these indicators, healthcare professionals and organizations can play a proactive role in addressing drug diversion concerns and ensuring patient safety and well-being.
Sarah Becker, RN, RAC-CT, DNS-CT, QCP
Clinical Consultant
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